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干针疗法对上斜方肌激痛点的影响:诱发局部抽搐反应对长期临床疗效的作用

The effect of dry needling on the active trigger point of upper trapezius muscle: Eliciting local twitch response on long-term clinical outcomes.

作者信息

Hakim Iman Kamali, Takamjani Ismail Ebrahimi, Sarrafzadeh Javad, Ezzati Kamran, Bagheri Rasool

机构信息

Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.

Neuroscience Research Center, Poorsina Hospital, Guilan University of Medical and Health Services, Rasht, Iran.

出版信息

J Back Musculoskelet Rehabil. 2019;32(5):717-724. doi: 10.3233/BMR-181286.

Abstract

BACKGROUND

Pain from myofascial trigger points is often treated by dry needling (DN). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. Muscle damage after eliciting LTR can increase the risk of tissue fibrosis in some cases.

OBJECTIVE

This study aimed to compare two methods of DN including with and without LTR on clinical parameters.

METHODS

Twenty-six participants suffering from chronic non-specific neck pain with an active trigger point (TrP) in their upper trapezius muscles were recruited via the convenience sampling method. Participants were randomly assigned in DN with LTR (control group) and without eliciting LTR or "de qi" (experimental group). Then, they received 3 sessions of dry needling, 3 days apart. We evaluated pain, pain pressure threshold, active cervical lateral flexion range of motion, and Neck Disability Index before the intervention and 4 weeks after the treatment.

RESULTS

After the treatment, significant higher changes were seen in the experimental group compared to the control group (p< 0.05) regarding pain, pain pressure threshold, and active cervical lateral flexion. However, there was no significant difference between groups according to the disability (p> 0.05).

CONCLUSION

DN without eliciting LTR has superiority over the DN along with eliciting LTR while the treatment aimed to receive long-term effects.

摘要

背景

肌筋膜触发点疼痛通常采用干针疗法(DN)进行治疗。经验证据表明,针刺过程中引发局部抽搐反应(LTR)至关重要。在某些情况下,引发LTR后肌肉损伤会增加组织纤维化的风险。

目的

本研究旨在比较两种干针疗法,即引发LTR和不引发LTR的干针疗法对临床参数的影响。

方法

通过便利抽样法招募了26名患有慢性非特异性颈部疼痛且上斜方肌有活跃触发点(TrP)的参与者。参与者被随机分为接受引发LTR的干针疗法组(对照组)和不引发LTR或“得气”的干针疗法组(实验组)。然后,他们接受3次干针治疗,每次间隔3天。我们在干预前和治疗后4周评估了疼痛、疼痛压力阈值、颈椎主动侧屈活动范围和颈部功能障碍指数。

结果

治疗后,实验组在疼痛、疼痛压力阈值和颈椎主动侧屈方面的变化显著高于对照组(p<0.05)。然而,根据功能障碍情况,两组之间没有显著差异(p>0.05)。

结论

在旨在获得长期效果的治疗中,不引发LTR的干针疗法比引发LTR的干针疗法更具优势。

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